Healthcare Provider Details

I. General information

NPI: 1528973567
Provider Name (Legal Business Name): JASMINE NICOLE CARMELITANO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 CRYSTAL RUN RD
MIDDLETOWN NY
10941-4060
US

IV. Provider business mailing address

67 OREGON TRL
PINE BUSH NY
12566-5328
US

V. Phone/Fax

Practice location:
  • Phone: 845-869-5024
  • Fax:
Mailing address:
  • Phone: 845-394-1425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number018451
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: